The Logistic Regression and ROC Analysis of Group-based Screening for Predicting Diabetes Incidence in Four Years

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In diabetes screening with hemoglobin A1c in lieu of plasma glucose, the optimumcut-off point for predicting the incidence of diabetes mellitus in the four-year periodwas examined. In addition, considerations were given on items in the screening andquestionnaire aside from hemoglobin A1c, which would be useful in predicting diabetesaside from hemoglobin A1c. The optimum cut-off point of hemoglobin A1c to predictdiabetes, based on receiver operating characteristic curve, was 5.3 percent (sensitivity,84.2%; specificity, 92.1%). Based on the logistic regression analysis, useful items(other than hemoglobin A1c) were alanine aminotransferase and γ-glutamyltranspeptidase. A combined application of hemoglobin A1c with alanineaminotransferase and γ-glutamyl transpeptidase for predicting the incidence ofdiabetes in the four-year period resulted in the sensitivity of 86.8% and the specificityof 96.3%. When the combined application was compared with the sole use ofhemoglobin A1c at 5.3%, the combined use was superior to the latter in terms of bothsensitivity and specificity, resulting in the reduction of false positives by more than50%.
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